Finding 1100932 (2024-001)

U.S. Department of Health and Human Services Passed through the N.C. Department of Health and Human Services, Division of Social Services Program Name: DSS Crosscutting (State) SNAP Cluster AL #10.561 (245NC406S2514) Finding: 2024-001 Significant Deficiency, non-material non-compliance Special Tests and Provisions (Enterprise Program Integrity) Criteria: Per the North Carolina DSS Crosscutting Requirements compliance supplement, Counties must acquire adequate case documentation to substantiate the claim entry into the NC Fast Enterprise Program Integrity (“EPI”) system. This information includes, but is not limited to the dates of the overpayment period, documentary evidence to substantiate that an overpayment occurred, such as wage stubs or verification from an employer, other income verification and household composition verification, and the budgets used to compute the amount of the overpayment. Condition: We noted instances of claims entered in EPI where adequate case documentation to substantiate the claim entry was not maintained. Context: We sampled 40 claims that were current in the EPI system and noted the above condition in 2 (5.0%) of the claims tested. For the first claim, the overpayment amount was incorrectly listed on the EPI420 compared to the DSS-1682 by an employee due to transposing a number. For the second claim, an overpayment amount was incorrectly listed on the EPI420 compared to the DSS-1682 by an employee keying in the “Less Adjustments” amount. Therefore, initial investigation in the claims file does not agree to the amount entered in EPI to be collected on by the County. Effect: The County may not have accurate supporting documentation for claims entered in EPI system. There is a risk that claims may not be valid as a result. Cause: Documentation to support a claim entered into EPI was not accurate. Questioned Costs: The finding represents an internal control weakness; therefore, no questioned costs are applicable. Upon further review, the cases were still eligible to report a claim entry into EPI. Recommendation: County DSS staff should implement controls to ensure that all documentation is maintained and agrees to what was entered into EPI. Views of Responsible Officials and Planned Corrective Actions: See Corrective Action Plan submitted with this report.